0684 Overnight Fluid Shift In Apnea And Stroke: Does Being Physically Active Matter

Abstract

Abstract Introduction Obstructive sleep apnea (OSA) and physical inactivity are frequent in patients with stroke. Overnight fluid shift may increase the propensity to pharyngeal obstruction and thus predispose to OSA. Also, physical inactivity can lead to consequent edema in the hemiparetic side. Methods In 7 patients at 3 months following post-first-ever ischemic stroke, we measured change in AHI (PSG), neck circumference, and arms and legs fluid volume (bioelectric impedance), before and after PSG in two conditions during the day before PSG: (1) inactive (sitting/lying), and (2) physically active (standing, walking, climbing stairs and mild exercise for 30 mins/hour). Results Being physically active for one day decreased mean AHI (inactive: 17.9/h; active: 12.6/h). Mean neck circumference increased overnight in both conditions (active and inactive) but increased more when the participants were physically active (inactive: 38 to 38.5cm; active: 38.43 to 39.5cm). Mean paretic arm fluid volume increased after inactive condition and did not change after physically active condition (inactive: 1.33L to 1.45L; active: 1.82L). Mean non-paretic arm fluid volume increased after active and inactive conditions (inactive: 1.34L to 1.45L; active: 1.74 to 1.78L). In both conditions and for paretic and non-paretic arms, being physically active for one day increased arm fluid volume between pre- and post-sleep comparisons. Mean paretic leg fluid volume increased after both conditions but increased more when the participants were inactive (inactive: 6.08L to 6.52L; active: 6.12 to 6.24L). Mean non-paretic leg fluid volume increased after inactive condition and decreased after being physically active (inactive: 6.01L to 6.45L; active: 6.15 to 6.06L). Conclusion Being physically active for one day decreased AHI, despite the increased fluid accumulation in the neck, and contributed to leaving no edema in the hemiparetic side. Breaking up inactivity and increasing physical activity in patients following stroke may be a promising intervention to reduce edema and OSA. Support São Paulo Research Foundation (FAPESP, grant #2018/18952-1 to CF).